Provider Demographics
NPI:1235596156
Name:BANISHAHI, AMIR A (DC)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:A
Last Name:BANISHAHI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1827 POWERS FERRY RD SE
Mailing Address - Street 2:BUILDING 7 , SUITE 150
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5621
Mailing Address - Country:US
Mailing Address - Phone:678-401-3803
Mailing Address - Fax:678-401-3803
Practice Address - Street 1:1827 POWERS FERRY RD SE
Practice Address - Street 2:BUILDING 7 , SUITE 150
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5621
Practice Address - Country:US
Practice Address - Phone:678-401-3803
Practice Address - Fax:678-401-3803
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-22
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR0099638111N00000X
GACHIR009638111NI0013X, 111NI0900X, 111NN0400X, 111NR0200X, 111NR0400X, 111NS0005X, 111NX0100X, 111NX0800X
CA33704111NS0005X, 111NI0013X, 111NI0900X, 111NN0400X, 111NX0800X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0013XChiropractic ProvidersChiropractorIndependent Medical Examiner
No111N00000XChiropractic ProvidersChiropractor
No111NI0900XChiropractic ProvidersChiropractorInternist
No111NN0400XChiropractic ProvidersChiropractorNeurology
No111NR0200XChiropractic ProvidersChiropractorRadiology
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NX0100XChiropractic ProvidersChiropractorOccupational Health
No111NX0800XChiropractic ProvidersChiropractorOrthopedic